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对手术、病理证实的36例壶腹部癌的临床与 CT 资料进行回顾性分析。其 CT 表现如下:(1)近梗阻端扩张的胆总管壁不规则或局限性增厚,其内密度不均或腔内软组织块影,以及十二指肠内侧壁的充盈缺损,这是本病的直接征象。(2)胰钩突内或钩突下可见扩张的胆总管。(3)双环影的显示率达86.1%,远远高于胰头癌,且可见双环影的上方或下方胆总管、胰管呈“蝌蚪样变形”。其形成是由于扫描层面恰好通过明显扩张的胆总管和平行扩张的胰管,具有较高的特异性。并与同期8例直径≤3 cm 的小胰头癌及胆总管远端阴性结石进行鉴别诊断。
A retrospective analysis of clinical and CT data of 36 cases of ampullary carcinoma confirmed by surgery and pathology was performed. The CT manifestations are as follows: (1) The common bile duct wall near the obstruction end is irregular or thickened, with uneven internal density or soft tissue mass in the lumen, and a filling defect of the inner wall of the duodenum. This is Direct signs of the disease. (2) The dilated common bile duct can be seen in the uncinate process or under the uncinate process. (3) The double annular image display rate was 86.1%, which was much higher than that of pancreatic head cancer, and the common bile duct or pancreatic duct above or under the double ring shadow showed “deformation”. Its formation is due to the fact that the scanning plane passes through the apparently dilated common bile duct and the parallel expanded pancreatic duct with high specificity. And 8 cases of small pancreatic head cancer with diameter ≤ 3 cm and distal common bile duct stones were differentially diagnosed with the same period.